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Peripheral Artery Disease (PAD): How Exercise Can Help

Unless you’re one of the 2.2 million people in the United States (according to the Centers of Disease Control (CDC) who have been diagnosed with Peripheral Artery Disease (PAD), it’s possible you’ve never even heard of it. And you would not be alone: a 2011 report from the American Heart Association estimates that only 25% of the population with PAD is aware that they have the disease.

But as numerous studies have noted, PAD is often undiagnosed; in fact, the SAGE group estimates that around 21 million Americans actually suffer from PAD, which means that more than 18 million Americans may have the disease without realizing it. In many cases, there is no cause for alarm — the Mayo Clinic notes that many PAD sufferers have mild symptoms or no symptoms at all.

What Are the Symptoms of PAD?

Some of the primary symptoms can be found here; if some (or all) of these symptoms apply to you, it’s a good idea to schedule an appointment with your medical provider for an examination. The number of undiagnosed PAD sufferers is due in large part to the fact that PAD is most common in people aged 70 and over (or aged 50 and over, if the individual has a history of diabetes or is a smoker); as a result, many PAD sufferers attribute these symptoms to the aging process. This can be a serious mistake, one that can have a potentially devastating impact on their long-term health.

Even if those symptoms don’t apply, undiagnosed PAD can still have serious consequences. The underlying cause of PAD is atherosclerosis, a buildup of plaque in the arteries. Left untreated, atherosclerosis and PAD can lead to an increased risk of coronary artery disease, stroke, and heart attack. In most cases, PAD affects blood flow to the legs, and the decreased flow of blood to the legs can lead to gangrene. And, though less common, PAD can also affect the flow of blood to the kidneys, stomach, head and arms.

How Is PAD Diagnosed?

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Many physicians check for PAD by simply feeling for a strong pulse in the ankle, although this method has been shown to be unreliable. A more advanced but time consuming test, the Ankle-Brachial Index or ABI, requires specialized equipment operated by a specially trained technician. Unfortunately the ABI test is often only prescribed after other symptoms are present despite the fact that many PAD patients show no symptoms.

More recently, an advanced PAD test called the QuantaFlo™ system is becoming more widely available in primary care offices throughout the country. With QuantaFlo, PAD testing can now be performed quickly and reliably by any medical assistant and has proven at least as accurate as previous technology.

What Can I Do If I Have PAD?

Fortunately, PAD is not only treatable, but with early detection, the treatment usually only consists of simple lifestyle changes. Smokers and people with diabetes are more likely to develop atherosclerosis and PAD, so smokers (especially those over the age of 50) should discuss a cessation plan with their medical provider.

Another simple lifestyle change is dietary changes — the goal is to lower the level of LDL cholesterol (that is, the “bad cholesterol”) in the blood, which is the primary cause of plaque buildup. Replacing foods that are high in LDL cholesterol with foods that are high in HDL cholesterol (what is known as “good cholesterol”) can help combat the effects of plaque buildup in the arteries.

Aside from those two changes, there’s another simple treatment that can dramatically decrease the symptoms of PAD: exercise.

How Exercise Can Help

PAD is what’s known as a “comorbid condition.” In other words, PAD doesn’t occur by itself — it’s a disease that only exists when another disease is present. Luckily, exercise can help.

For starters, exercise will help lower the LDL cholesterol and increase the HDL cholesterol in the blood, and when it’s paired with the right diet, exercise can be tremendously helpful. On top of that, exercise helps control high blood pressure and can contribute to weight loss. This means a lower risk of diabetes, which increases the risk of PAD.

Because symptoms of PAD include leg pain (known as “claudication”), finding the proper exercise regimen can be difficult. Overexertion will lead to more leg pain, and very few individuals are able to exercise through pain — especially when the exercise itself is the source of the pain.

The National Heart, Lung, and Blood Institute (NIH) offers exercise guidelines. The NIH recommends at least 1 hour and 15 minutes of “vigorous aerobic exercise per week” for those who are able. For those unable to perform high-intensity exercise, the NIH suggests 2.5 hours of “moderate-intensity aerobic exercise per week” as an alternative. Individuals should always check with their medical provider before starting an exercise program — providers will help their patients determine how often and how vigorously they should exercise.

Although it may cause discomfort initially, a consistent exercise regimen will help clear up the plaque buildup, and over time, the leg pain that comes with PAD will lessen. Not only will exercise enable those with PAD to enjoy their lives more fully, but it will also ensure that the PAD does not progress into something more serious.